My new avatar.

After a long time, I got my head completely shaved :) This is to avoid the irritation on the skin and to avoid any infections.

Metabolic alterations

Today, I had my third dose of Neupogen at Ketham's Hospital, Vidyaranyapura. The effects of the injection have been drowsiness and mild dullness in the body, which is making me sleep for extended hours in the day time too! My eyes would become red and skin succumbed to reddish sores on the chest and lower waist! It is a minor irritation to have the injection daily on one side and to have the side-effects in the body working on the other!

Now-a-days, it will not be before 7 AM, I wake up in the morning. This is contrary to the earlier times, when I used to break my sleep at around 5:30 AM. More chemotherapy toxins in the body and resulting restlessness is forcing the body to take sleep at irregular intervals. These disturbances in the body metabolism will definitely have long-term effect on my normal life. I hope once I win against the disease, I need to spend considerable time in bringing the body back to its correct metabolic rates.

Jumping around?

Today, I had an afternoon nap for around two hours. In the strict sense, it should not called a nap, though. :)
Because of the tablets and the toxins moving inside my body, there is some kind of irritation inside which I cannot explain. I always feel to jump around whenever I am awake but my colostomy pouch should permit me doing that!

Last Friday, I had my fourth cycle of chemotherapy at BIO with Cetuximab and Irinitecan. I continued the oral administration of Xeloda, 3 x 500 mg in the morning and 3 x 500 mg in the night! I had been taking the same drugs for my earlier doses of chemotherapy too and the resulting side-effects, more important one, had been tremendous loss of hair! (See my pics attached!)

Also, I was advised to take the Neupogen injection per day for four days since the administration of Irinotecan may induce neutrohil count to go down in the blood. Since the injection is the sub-cutaneous one and given that BIO is around 16 kms from my home, I preferred to take the injection in the local Ketham's Hospital. :)

Often, for some, there would be long hiatus in life for several reasons - depression troughs, busyness in life or critical illness. The hiatus and the ensuing vacuum would be very difficult in the sense that it takes a sustained, long and dedicated effort to get back to the mode which you leave before the hiatus. Sometimes, this break in the life is helpful and sometimes is sickening.

Ever since I was diagnosed with colo-rectal cancer (CRC) early October 2008, I have been off from my active life - a stage of life where I had my feet in work, research, reading and play. The suffering has been so huge that my mind was not thinking anything else except the disease and the resulting pain. I did not have a chance even to sit and key-in my thoughts in my blogging world! It had been an old idea to capture all my experiences over this most painful suffering I have ever experienced in my life until now in the form of a written diary - either a printed form or an online resource. This blog serves and helps me in thinking myself out while going though this painful phase in my life.

To have a brief on the happenings over the past one year, here is a gist:

September 2008

• had severe anal pain and bleeding while passing stools
• consulted a local physician in Bangalore and took pain-killers and laxatives
• visited the family doctor in my hometown (Kadapa, A.P.) and had a diagnosis

October 2008

• had a biopsy test in Chennai after my family doctor referred the case to a specialist
• diagnosed with colo-rectal cancer (CRC)
  
• decided on taking radiotherapy in VS Hospitals, Egmore, Chennai
• had a prognosis test in the form of KRAS, which showed that the tumour is gene-mutation negative
  
• did semen banking in Prashant Hospitals, Chennai, since it is the prerequisite and recommended step prior to taking radiotherapy
• first PET CT scan done to know the extent of the disease (it was at Stage IIIb)
• started radiotherapy in the mid-October with 5 daily doses of radiation for 6 weeks coupled with Oxaliplatin-based chemotherapy every week

November 2008

• returned from Chennai to my hometown for taking rest for 2 months. (This rest was necessary after radiotherapy before further treatment).
  
• suffered with proctitis
  

December 2008

• stayed at Kadapa, my hometown for post-radiotherapy rest

January 2009

• returned to Bangalore to plan for a permanent colostomy surgery at Apollo Hospitals
• a PET CT scan confirmed the metastasis of the disease with its spread to liver and lung!
  
• Dr.Bapsy of Apollo Hospitals recommended Avastin-based chemotherapy along with 5FU and Oxaliplatin
  

February 2009

• started chemotherapy at Apollo Hospitals, Bangalore

March 2009

• continued chemotherapy at Apollo Hospitals, Bangalore
• had another PET CT scan after 3 cycles of chemotherapy. The scan this time shows improvement in the recession of the disease though not remarkable. Dr.Bapsy advised to continue the chemotherapy with the same protocol.

April 2009

• had Salmonella bacteria infection and admitted to the Apollo Hospitals for a week. Survived with severe symptoms of diarrhea and fever
• chemotherapy stopped because of infections. (It is not advisable to have chemotherapy when body is infected)

May 2009

• admitted to Apollo Hospitals due to an abscess in the rectal area
• got the abscess drained. Doctors, Vijay Kumar and Nawab Jaan of Apollo Hospitals advised at least a four-week rest before the surgery so that the drained abscess would heal.

June 2009

• not convinced with the Apollo's team of doctors on the state and curability of the disease, took the opinion of Dr.K.S.Gopinath of Bangalore Institute of Oncology (BIO)
• had a temporary colostomy surgery by the team headed by Dr.K.S.Gopinath

July 2009

• consulted Dr.Niti Narang, a medical oncologist with BIO on further chemotherapy
• a PET CT scan showed a progressive disease :-(
  
• started chemotherapy at BIO, the protocol including Cetuximab, Irinotecan and Xeloda

August 2009

• started chemotherapy at BIO, the protocol including Cetuximab, Irinotecan and Xeloda
• admitted once to the BIO for cure of low neutrophils in the blood and got administered Neupogen

As recent as last week, I had another PET CT scan which showed good response to the chemotherapy and the disease got reduced by at least 60%! :-) Dr.Niti advised continuing the same protocol of the chemotherapy.